Details

Autor(en) / Beteiligte

• Mercer, Mary P., MD, MPH
• Mahadevan, Swaminatha V., MD
• Pirrotta, Elizabeth, PhD
• Ramana Rao, G.V., MD
• Sistla, Sreeram, MD
• Nampelly, Bhanuprasad
• Danthala, Rajini
• Strehlow, Anne N.T., PhD
• Strehlow, Matthew C., MD

Titel

Epidemiology of Shortness of Breath in Prehospital Patients in Andhra Pradesh, India

Ist Teil von

• The Journal of emergency medicine, 2015-10, Vol.49 (4), p.448-454

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2015

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background Shortness of breath is a frequent reason for patients to request prehospital emergency medical services and is a symptom of many life-threatening conditions. To date, there is limited information on the epidemiology of, and outcomes of patients seeking emergency medical services for, shortness of breath in India. Objective This study describes the characteristics and outcomes of patients with a chief complaint of shortness of breath transported by a public ambulance service in the state of Andhra Pradesh, India. Methods This prospective, observational study enrolled patients with a chief complaint of shortness of breath during twenty-eight, 12-h periods. Demographic and clinical data were collected from emergency medical technicians using a standardized questionnaire. Follow-up information was collected at 48–72 h and 30 days. Results Six hundred and fifty patients were enrolled during the study period. The majority of patients were male (63%), from rural communities (66%), and of lower socioeconomic status (78%). Prehospital interventions utilized included oxygen (76%), physician consultation (40%), i.v. placement (15%), nebulized medications (13%), cardiopulmonary resuscitation (5%), and bag-mask ventilation (4%). Mortality ratios before hospital arrival, at 48–72 h, and 30 days were 12%, 27%, and 35%, respectively. Forty-six percent of patients were confirmed to have survived to 30 days. Predictors of death before hospital arrival were symptoms of chest pain (16% vs. 12%; p  < 0.05) recent symptoms of upper respiratory infection (7.5% vs. 4%; p  < 0.05), history of heart disease (14% vs. 7%; p  < 0.05), and prehospital hypotension, defined as systolic blood pressure <90 mm Hg (6.3% vs. 3.7%; p  < 0.05). Conclusions Among individuals seeking prehospital emergency medical services in India, the chief complaint of shortness of breath is associated with a substantial early and late mortality, which may be in part due to the underutilization of prehospital interventions.